On the pulse

At the RCN Congress in Liverpool this week, some of the most pressing issues facing the nursing profession were on the agenda. In particular, two stories covered by Nursing Times highlighted the need for greater awareness of the value of some nursing roles.

NMC fee to rise to £100 in February

Nurses will pay £100 to register with the Nursing and Midwifery Council from February, following a decision by the regulator today.

The NMC council has chosen to increase the fee by 32% from £76 to £100 for two years, after which it will rise to £120. This replaces its original plan to move straight to £120 in January 2013, which would have represented a 58% increase.

The fee rise will have to approved by the Privy Council. However, today’s decision at the NMC council’s latest meeting in London seemingly brings to an end the saga that first erupted in May, when it first proposed increasing the fee.

Since then the NMC has doggedly stuck to its position that the hike is necessary to shore up its finances and protect the public, despite anger from registrants and opposition from unions.

Its current registration fee of £76 per annum was implemented in August 2007, and generates income of £52m per annum. However, the regulator has seen a significant rise in fitness to practise referrals in recent years, which it predicts will rise even further over the next few years.

According to council papers, direct expenditure on fitness to practise in 2011-2012 was £31m, a 50% increase on the prior year. Total NMC revenue expenditure was £61m and total revenue was £53m, creating a deficit of £8m, which was effectively funded by reserves.

The government offered the regulator a grant of £20m earlier this month to ease its financial problems and negate the need for such a steep fee hike. The NMC chose to accept the grant at the meeting today.

The regulator’s ruling council discussed four options this morning at its latest meeting, some of which included accepting the grant and some not.

One option would have seen no fee increase and the £20m grant accepted. But it would almost certainly have resulted in a scaling back of fitness to practise and other regulatory activity, meaning the NMC would be failing to fulfil its core remit of public protection.

The second option would have seen the £20m grant rejected and resulted in the annual registration fee rise to £120 next year, as originally proposed by the NMC.

The third option, which was chosen by the majority of council members, will see the fee rise to £100 for two years and then £120 after that. This option includes the NMC accepting the government grant.

A fourth option would have seen the fee rise to £95 in 2013-14, £105 in 2014-2015, £120 in 2015-16.

As revealed by Nursing Times this week, the NMC has bowed to pressure and commissioned financial consultants KPMG to audit the sums behind its fee rise.

The regulator had previously rejected such a move and claimed its business case was sound, despite two letters from former health secretary Andrew Lansley asking it to commission the work.

The results of the KPMG review were also due to be presented this morning at the council meeting.

Despite being a lower fee hike than previously threatened, Unison descibed the 32% increase as “unfair and disproportionate” in the light of the £20m grant offered by the government.

Unison head of nursing Gail Adams said: “This is an appalling move by the NMC. There is no justice in making nurses and midwives – who have had no pay rise for two years – pay for the past financial mismanagement of the NMC.

“The NMC could, and should have postponed this decision and used the time to rebuild the trust and confidence of registrants. There was nothing to stop the NMC from freezing registration fees and reviewing the situation next year; they could then use the grant to start addressing the backlog of fitness to practise cases.”

Royal College of Nursing chief executive and general secretary Peter Carter said: “Nurses across the UK have repeatedly objected to the proposed hike in NMC fees, at a time when many are struggling financially.

“We are staggered that with an increase of over 30%, the NMC is still asking for frontline nurses to pay the penalty for a problem which is not of their making. We are also staggered that nurses are still being asked to pay for the failures of their regulator, with no real assurance that the fundamental problems will be solved.

“We still need to see the outcome of a full financial audit, and the profession needs to have confidence that the lessons are learnt from this fiasco and that there will be ongoing, high-level scrutiny of the organisation. Without this, nurses and the government could end up throwing good money after bad.”

“The RCN welcomed the Department of Health’s offer, which our members have called for repeatedly. Now more than ever, they will want to be reassured about the long term future of their professional regulation. A strong and effective nursing regulator is vital for the public, patients and the future of the nursing profession.”

Louise Silverton, director for midwifery at the Royal College of Midwives, said: “‘The RCM has worked hard to get the best possible result for its members, and we are pleased that we’ve achieved something by lobbying for the £20m grant from the government that the NMC has accepted.

“Many of the NMC council members took on-board our concerns about the effects the fee increase will have, particularly on those who only work a few hours a week and on newly qualified midwives.”

She added: “No one is happy to see an increase, but the NMC have committed to an annual review of the situation which will allow us to see if the NMC’s assumptions about its finances are accurate. The NMC’s suggestion that fees could go down if predictions aren’t as they expect is welcome.”

More details on the NMC’s decision and response to follow. Follow @sjcalkin on Twitter for live updates from the meeting.

Nurses and midwives will have to pay £100 instead of £76 to register with the Nursing and Midwifery Council from the beginning of next month, in line with the regulator’s decision to increase its fees.

The Nursing and Midwifery Council’s decision to increase the registration fee by almost a third has been condemned by unions, amid concerns the move will have a disproportionate effect on part time staff.

Readers' comments (67)

I recently went to the NMC buildings in Aldwych and in Portland place. It was clear that a huge amount of our money is being spent on these state of the art premises.
We saw several Starbucks coffee orders arrive while we (and staff) sat around waiting for the only hearing they had on that day to start. I wonder how much it costs for them to employ so many staff in several central London locations? They clearly have better working conditions than nurses.

Wow. I'm just joining the nursing profession and have had to rely on student loans and NHS bursaries to survive. The £76 fee I recently paid was too much for me - had to borrow it from a relative.

If this was some sort of fee that was paid every three years instead of annually, then maybe I'd be more open to this rise. But to (eventually) pay £120/year in order to do a job I've always wanted to do? It's too much.

I understand the NMC's role, and of course it's a necessary organisation. But to ignore the thousands of nurses & midwives and to ignore the unions that have fought against this...it's unacceptable.

I don't think nurses would mind the exhorbitant fees so much if we had a decent regulator that was open and honest but all we see is a group of people shacked up in a really expensive property doing a job that isn't fit for purpose. Perhaps if they pulled their collective fingers out and actually expedited some of these hearings (I think 2014 was a suggested completion date for the current batch), they'd save a lot of our money.

Not worth it will consider joining an agency as a H C A many of whom get the same pay as an N H S nurse Thornbury more in some cases less stress and no worries about fees and finding the money I too remember paying
£36 every 3 years can't really say I've noticed any benefits with the increase to be honest been disillusioned for a while now this just makes it easy to admit time to leave

This is taking the biscuit, taking tax payers money and raising fees. Who's not fit for practice?
With the rises, I guess the tax office will receive about £6 and £11 less per registrant when reg fees are £100 and £120 respectively which each of us are hit with. How many registrants are there? That's a few million pounds out of the hmrc coffers.
So we're all paying for NMC staff pay rises when we've got a bigger pay cut.
The question should be what are we going to do about it, not just leaving it to the unions or government, as not all registrants are in unions, but are all tax payers paying for someone else's mistakes. I wouldn't trust this government to bail out a boat, no chance with a sinking ship + a poor economy.

maybe they never intended to put the fees up to 120, it was just a ruse so that when they 'agreed' to a figure of 100 (which was probably their intention in the first place) we wouldn't mind so much.

I don't believe for one second that this fee increase is justified, they do nothing for nurses.

Why can't they come forward and tell us why they expect US to pay for the nursing homes and mid-staff failings, why not fine the hospital board who failed to take notice when staff raised concerns.

I should like them to publish details of what they are going to do for ME, if they have a backlog of FtP hearings that cost a fortune that is not my concern. I want to know what I am getting for my money.

They keep saying they need the money to protect the public, trying to make us feel responsible. If there are so many bad nurses out there how come they were allowed on the register in the first place, PREP was a pointless exercise which no doubt cost a fortune too.

The NMC needs a dose of size 10 to its corporate arse. It needs to get out of London and stop its ridiculous processes that allow cases to run up huge expenses bills. I work for a voluntary organisation that used to make a contribution to lost expenses, I wonder what changes have been made in budgeting for expense reimbursement at the NMC over the last few years?

There are somethings that everyone who reads this article, can do.
Write to your local MP.
Sign the petition http://epetitions.direct.gov.uk/petitions/36678
Email the NMC directly and complain/put your views mailto:UKenquiries@nmc-uk.org
Do something constructive instead of moaning about it and maybe, just maybe, something will happen.

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